ArticleNeurology2024
Natriuretic Peptides to Classify Risk of Atrial Fibrillation Detection After Stroke: Analysis of the BIOSIGNAL and PRECISE Cohort Studies.
Registry-linked trialAbstract read
In one paragraph
Article in Neurology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02274727 (Biomarker Signature of Stroke Aetiology Study), which is not on this map. Cited by 7 papers, 2 of them syntheses that pooled it.
0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 2 pooled it
–field-weighted citation impact
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Biomarker Signature of Stroke Aetiology Study: The BIOSIGNAL-Study
Who cites it
7 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Serum biomarkers insights into occult atrial fibrillation related to embolic strokes of undetermined source: a narrative review.BMC neurology · 2026Pooled it
- Association of MR-proANP Circulating Levels with Ischemic Stroke of Cardioembolic Etiology: A Systematic Review and Meta-Analysis.Translational stroke research · 2025Pooled it
- Risk of Stroke, Thromboembolism and Mortality in Atrial Fibrillation Patients Across Different Stages and Types of Heart Failure: A Retrospective Cohort Study.Journal of clinical medicine · 2026Article
- Predicting Incident Atrial Fibrillation after Stroke: A Scoping Review of Clinical Scores, Biomarkers, and AI-Enhanced Strategies.Cerebrovascular diseases extra · 2026Article
- From Detection to Decision: Managing Device-Detected Atrial Fibrillation After Stroke.Current neurology and neuroscience reports · 2025Review
- High-Sensitivity Cardiac Troponin as a Predictor of Atrial Fibrillation Detected After Stroke: Implications for Subsequent Cerebrocardiovascular Events.Journal of clinical medicine · 2025Article
- Ischemic stroke prevention in patients with atrial fibrillation and a recent ischemic stroke, TIA, or intracranial hemorrhage: A World Stroke Organization (WSO) scientific statement.International journal of stroke : official journal of the International Stroke Society · 2025Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
22 authors.
Alan C CameronFrom the School of Cardiovascular and Metabolic Health (A.C.C., G. Katsas, J.Y., T.J.Q., R.C., K.D., J.D.), University of Glasgow, United Kingdom; Department of Neurology (Markus Arnold), University Hospital Zurich, Switzerland; Liverpool Centre for Cardiovascular Science (A.H.A.-R.), and Cardiovascular and Metabolic Medicine (A.H.A.-R.), Institute of Life Course and Medical Sciences, University of Liverpool, United Kingdom; Department of Neurology and Stroke Centre (G.M.D.M., M.K.), University Hospital Basel and University of Basel; Department of Neurology (Marcel Arnold), University Hospital Bern; Department of Neurology and Stroke Center (T.K., K.N.), Cantonal Hospital Aarau; Department of Neurology (C.W.C.), Neurocenter (EOC) of Southern Switzerland, Lugano; Department of Neurology (G. Kägi), Cantonal Hospital St. Gallen, Switzerland; Neurology Service (A.B.), Germans Trias i Pujol University Hospital, Barcelona; Neurovascular Research Group (J.M.), Biomedicine Institute of Seville, Spain; Department of Internal Medicine (G.N.), Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece; Department of Neurology (C.F.), Goethe University, Frankfurt am Main, Germany; and Institute of Clinical Chemistry (K.S., A.V.E.), University Hospital of Zurich, Switzerland.ORCID 0000-0001-6965-1109
Markus ArnoldFrom the School of Cardiovascular and Metabolic Health (A.C.C., G. Katsas, J.Y., T.J.Q., R.C., K.D., J.D.), University of Glasgow, United Kingdom; Department of Neurology (Markus Arnold), University Hospital Zurich, Switzerland; Liverpool Centre for Cardiovascular Science (A.H.A.-R.), and Cardiovascular and Metabolic Medicine (A.H.A.-R.), Institute of Life Course and Medical Sciences, University of Liverpool, United Kingdom; Department of Neurology and Stroke Centre (G.M.D.M., M.K.), University Hospital Basel and University of Basel; Department of Neurology (Marcel Arnold), University Hospital Bern; Department of Neurology and Stroke Center (T.K., K.N.), Cantonal Hospital Aarau; Department of Neurology (C.W.C.), Neurocenter (EOC) of Southern Switzerland, Lugano; Department of Neurology (G. Kägi), Cantonal Hospital St. Gallen, Switzerland; Neurology Service (A.B.), Germans Trias i Pujol University Hospital, Barcelona; Neurovascular Research Group (J.M.), Biomedicine Institute of Seville, Spain; Department of Internal Medicine (G.N.), Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece; Department of Neurology (C.F.), Goethe University, Frankfurt am Main, Germany; and Institute of Clinical Chemistry (K.S., A.V.E.), University Hospital of Zurich, Switzerland.
Georgios KatsasFrom the School of Cardiovascular and Metabolic Health (A.C.C., G. Katsas, J.Y., T.J.Q., R.C., K.D., J.D.), University of Glasgow, United Kingdom; Department of Neurology (Markus Arnold), University Hospital Zurich, Switzerland; Liverpool Centre for Cardiovascular Science (A.H.A.-R.), and Cardiovascular and Metabolic Medicine (A.H.A.-R.), Institute of Life Course and Medical Sciences, University of Liverpool, United Kingdom; Department of Neurology and Stroke Centre (G.M.D.M., M.K.), University Hospital Basel and University of Basel; Department of Neurology (Marcel Arnold), University Hospital Bern; Department of Neurology and Stroke Center (T.K., K.N.), Cantonal Hospital Aarau; Department of Neurology (C.W.C.), Neurocenter (EOC) of Southern Switzerland, Lugano; Department of Neurology (G. Kägi), Cantonal Hospital St. Gallen, Switzerland; Neurology Service (A.B.), Germans Trias i Pujol University Hospital, Barcelona; Neurovascular Research Group (J.M.), Biomedicine Institute of Seville, Spain; Department of Internal Medicine (G.N.), Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece; Department of Neurology (C.F.), Goethe University, Frankfurt am Main, Germany; and Institute of Clinical Chemistry (K.S., A.V.E.), University Hospital of Zurich, Switzerland.
Jason YangFrom the School of Cardiovascular and Metabolic Health (A.C.C., G. Katsas, J.Y., T.J.Q., R.C., K.D., J.D.), University of Glasgow, United Kingdom; Department of Neurology (Markus Arnold), University Hospital Zurich, Switzerland; Liverpool Centre for Cardiovascular Science (A.H.A.-R.), and Cardiovascular and Metabolic Medicine (A.H.A.-R.), Institute of Life Course and Medical Sciences, University of Liverpool, United Kingdom; Department of Neurology and Stroke Centre (G.M.D.M., M.K.), University Hospital Basel and University of Basel; Department of Neurology (Marcel Arnold), University Hospital Bern; Department of Neurology and Stroke Center (T.K., K.N.), Cantonal Hospital Aarau; Department of Neurology (C.W.C.), Neurocenter (EOC) of Southern Switzerland, Lugano; Department of Neurology (G. Kägi), Cantonal Hospital St. Gallen, Switzerland; Neurology Service (A.B.), Germans Trias i Pujol University Hospital, Barcelona; Neurovascular Research Group (J.M.), Biomedicine Institute of Seville, Spain; Department of Internal Medicine (G.N.), Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece; Department of Neurology (C.F.), Goethe University, Frankfurt am Main, Germany; and Institute of Clinical Chemistry (K.S., A.V.E.), University Hospital of Zurich, Switzerland.
Terence J QuinnFrom the School of Cardiovascular and Metabolic Health (A.C.C., G. Katsas, J.Y., T.J.Q., R.C., K.D., J.D.), University of Glasgow, United Kingdom; Department of Neurology (Markus Arnold), University Hospital Zurich, Switzerland; Liverpool Centre for Cardiovascular Science (A.H.A.-R.), and Cardiovascular and Metabolic Medicine (A.H.A.-R.), Institute of Life Course and Medical Sciences, University of Liverpool, United Kingdom; Department of Neurology and Stroke Centre (G.M.D.M., M.K.), University Hospital Basel and University of Basel; Department of Neurology (Marcel Arnold), University Hospital Bern; Department of Neurology and Stroke Center (T.K., K.N.), Cantonal Hospital Aarau; Department of Neurology (C.W.C.), Neurocenter (EOC) of Southern Switzerland, Lugano; Department of Neurology (G. Kägi), Cantonal Hospital St. Gallen, Switzerland; Neurology Service (A.B.), Germans Trias i Pujol University Hospital, Barcelona; Neurovascular Research Group (J.M.), Biomedicine Institute of Seville, Spain; Department of Internal Medicine (G.N.), Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece; Department of Neurology (C.F.), Goethe University, Frankfurt am Main, Germany; and Institute of Clinical Chemistry (K.S., A.V.E.), University Hospital of Zurich, Switzerland.ORCID 0000-0003-1401-0181
Azmil H Abdul-RahimFrom the School of Cardiovascular and Metabolic Health (A.C.C., G. Katsas, J.Y., T.J.Q., R.C., K.D., J.D.), University of Glasgow, United Kingdom; Department of Neurology (Markus Arnold), University Hospital Zurich, Switzerland; Liverpool Centre for Cardiovascular Science (A.H.A.-R.), and Cardiovascular and Metabolic Medicine (A.H.A.-R.), Institute of Life Course and Medical Sciences, University of Liverpool, United Kingdom; Department of Neurology and Stroke Centre (G.M.D.M., M.K.), University Hospital Basel and University of Basel; Department of Neurology (Marcel Arnold), University Hospital Bern; Department of Neurology and Stroke Center (T.K., K.N.), Cantonal Hospital Aarau; Department of Neurology (C.W.C.), Neurocenter (EOC) of Southern Switzerland, Lugano; Department of Neurology (G. Kägi), Cantonal Hospital St. Gallen, Switzerland; Neurology Service (A.B.), Germans Trias i Pujol University Hospital, Barcelona; Neurovascular Research Group (J.M.), Biomedicine Institute of Seville, Spain; Department of Internal Medicine (G.N.), Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece; Department of Neurology (C.F.), Goethe University, Frankfurt am Main, Germany; and Institute of Clinical Chemistry (K.S., A.V.E.), University Hospital of Zurich, Switzerland.ORCID 0000-0002-1318-4027
Ross CampbellFrom the School of Cardiovascular and Metabolic Health (A.C.C., G. Katsas, J.Y., T.J.Q., R.C., K.D., J.D.), University of Glasgow, United Kingdom; Department of Neurology (Markus Arnold), University Hospital Zurich, Switzerland; Liverpool Centre for Cardiovascular Science (A.H.A.-R.), and Cardiovascular and Metabolic Medicine (A.H.A.-R.), Institute of Life Course and Medical Sciences, University of Liverpool, United Kingdom; Department of Neurology and Stroke Centre (G.M.D.M., M.K.), University Hospital Basel and University of Basel; Department of Neurology (Marcel Arnold), University Hospital Bern; Department of Neurology and Stroke Center (T.K., K.N.), Cantonal Hospital Aarau; Department of Neurology (C.W.C.), Neurocenter (EOC) of Southern Switzerland, Lugano; Department of Neurology (G. Kägi), Cantonal Hospital St. Gallen, Switzerland; Neurology Service (A.B.), Germans Trias i Pujol University Hospital, Barcelona; Neurovascular Research Group (J.M.), Biomedicine Institute of Seville, Spain; Department of Internal Medicine (G.N.), Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece; Department of Neurology (C.F.), Goethe University, Frankfurt am Main, Germany; and Institute of Clinical Chemistry (K.S., A.V.E.), University Hospital of Zurich, Switzerland.
Kieran DochertyFrom the School of Cardiovascular and Metabolic Health (A.C.C., G. Katsas, J.Y., T.J.Q., R.C., K.D., J.D.), University of Glasgow, United Kingdom; Department of Neurology (Markus Arnold), University Hospital Zurich, Switzerland; Liverpool Centre for Cardiovascular Science (A.H.A.-R.), and Cardiovascular and Metabolic Medicine (A.H.A.-R.), Institute of Life Course and Medical Sciences, University of Liverpool, United Kingdom; Department of Neurology and Stroke Centre (G.M.D.M., M.K.), University Hospital Basel and University of Basel; Department of Neurology (Marcel Arnold), University Hospital Bern; Department of Neurology and Stroke Center (T.K., K.N.), Cantonal Hospital Aarau; Department of Neurology (C.W.C.), Neurocenter (EOC) of Southern Switzerland, Lugano; Department of Neurology (G. Kägi), Cantonal Hospital St. Gallen, Switzerland; Neurology Service (A.B.), Germans Trias i Pujol University Hospital, Barcelona; Neurovascular Research Group (J.M.), Biomedicine Institute of Seville, Spain; Department of Internal Medicine (G.N.), Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece; Department of Neurology (C.F.), Goethe University, Frankfurt am Main, Germany; and Institute of Clinical Chemistry (K.S., A.V.E.), University Hospital of Zurich, Switzerland.
Gian Marco De MarchisFrom the School of Cardiovascular and Metabolic Health (A.C.C., G. Katsas, J.Y., T.J.Q., R.C., K.D., J.D.), University of Glasgow, United Kingdom; Department of Neurology (Markus Arnold), University Hospital Zurich, Switzerland; Liverpool Centre for Cardiovascular Science (A.H.A.-R.), and Cardiovascular and Metabolic Medicine (A.H.A.-R.), Institute of Life Course and Medical Sciences, University of Liverpool, United Kingdom; Department of Neurology and Stroke Centre (G.M.D.M., M.K.), University Hospital Basel and University of Basel; Department of Neurology (Marcel Arnold), University Hospital Bern; Department of Neurology and Stroke Center (T.K., K.N.), Cantonal Hospital Aarau; Department of Neurology (C.W.C.), Neurocenter (EOC) of Southern Switzerland, Lugano; Department of Neurology (G. Kägi), Cantonal Hospital St. Gallen, Switzerland; Neurology Service (A.B.), Germans Trias i Pujol University Hospital, Barcelona; Neurovascular Research Group (J.M.), Biomedicine Institute of Seville, Spain; Department of Internal Medicine (G.N.), Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece; Department of Neurology (C.F.), Goethe University, Frankfurt am Main, Germany; and Institute of Clinical Chemistry (K.S., A.V.E.), University Hospital of Zurich, Switzerland.ORCID 0000-0002-0342-9780
Marcel ArnoldFrom the School of Cardiovascular and Metabolic Health (A.C.C., G. Katsas, J.Y., T.J.Q., R.C., K.D., J.D.), University of Glasgow, United Kingdom; Department of Neurology (Markus Arnold), University Hospital Zurich, Switzerland; Liverpool Centre for Cardiovascular Science (A.H.A.-R.), and Cardiovascular and Metabolic Medicine (A.H.A.-R.), Institute of Life Course and Medical Sciences, University of Liverpool, United Kingdom; Department of Neurology and Stroke Centre (G.M.D.M., M.K.), University Hospital Basel and University of Basel; Department of Neurology (Marcel Arnold), University Hospital Bern; Department of Neurology and Stroke Center (T.K., K.N.), Cantonal Hospital Aarau; Department of Neurology (C.W.C.), Neurocenter (EOC) of Southern Switzerland, Lugano; Department of Neurology (G. Kägi), Cantonal Hospital St. Gallen, Switzerland; Neurology Service (A.B.), Germans Trias i Pujol University Hospital, Barcelona; Neurovascular Research Group (J.M.), Biomedicine Institute of Seville, Spain; Department of Internal Medicine (G.N.), Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece; Department of Neurology (C.F.), Goethe University, Frankfurt am Main, Germany; and Institute of Clinical Chemistry (K.S., A.V.E.), University Hospital of Zurich, Switzerland.ORCID 0000-0002-4274-4644
Timo KahlesFrom the School of Cardiovascular and Metabolic Health (A.C.C., G. Katsas, J.Y., T.J.Q., R.C., K.D., J.D.), University of Glasgow, United Kingdom; Department of Neurology (Markus Arnold), University Hospital Zurich, Switzerland; Liverpool Centre for Cardiovascular Science (A.H.A.-R.), and Cardiovascular and Metabolic Medicine (A.H.A.-R.), Institute of Life Course and Medical Sciences, University of Liverpool, United Kingdom; Department of Neurology and Stroke Centre (G.M.D.M., M.K.), University Hospital Basel and University of Basel; Department of Neurology (Marcel Arnold), University Hospital Bern; Department of Neurology and Stroke Center (T.K., K.N.), Cantonal Hospital Aarau; Department of Neurology (C.W.C.), Neurocenter (EOC) of Southern Switzerland, Lugano; Department of Neurology (G. Kägi), Cantonal Hospital St. Gallen, Switzerland; Neurology Service (A.B.), Germans Trias i Pujol University Hospital, Barcelona; Neurovascular Research Group (J.M.), Biomedicine Institute of Seville, Spain; Department of Internal Medicine (G.N.), Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece; Department of Neurology (C.F.), Goethe University, Frankfurt am Main, Germany; and Institute of Clinical Chemistry (K.S., A.V.E.), University Hospital of Zurich, Switzerland.
Krassen NedeltchevFrom the School of Cardiovascular and Metabolic Health (A.C.C., G. Katsas, J.Y., T.J.Q., R.C., K.D., J.D.), University of Glasgow, United Kingdom; Department of Neurology (Markus Arnold), University Hospital Zurich, Switzerland; Liverpool Centre for Cardiovascular Science (A.H.A.-R.), and Cardiovascular and Metabolic Medicine (A.H.A.-R.), Institute of Life Course and Medical Sciences, University of Liverpool, United Kingdom; Department of Neurology and Stroke Centre (G.M.D.M., M.K.), University Hospital Basel and University of Basel; Department of Neurology (Marcel Arnold), University Hospital Bern; Department of Neurology and Stroke Center (T.K., K.N.), Cantonal Hospital Aarau; Department of Neurology (C.W.C.), Neurocenter (EOC) of Southern Switzerland, Lugano; Department of Neurology (G. Kägi), Cantonal Hospital St. Gallen, Switzerland; Neurology Service (A.B.), Germans Trias i Pujol University Hospital, Barcelona; Neurovascular Research Group (J.M.), Biomedicine Institute of Seville, Spain; Department of Internal Medicine (G.N.), Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece; Department of Neurology (C.F.), Goethe University, Frankfurt am Main, Germany; and Institute of Clinical Chemistry (K.S., A.V.E.), University Hospital of Zurich, Switzerland.ORCID 0000-0002-7614-1227
Carlo W CeredaFrom the School of Cardiovascular and Metabolic Health (A.C.C., G. Katsas, J.Y., T.J.Q., R.C., K.D., J.D.), University of Glasgow, United Kingdom; Department of Neurology (Markus Arnold), University Hospital Zurich, Switzerland; Liverpool Centre for Cardiovascular Science (A.H.A.-R.), and Cardiovascular and Metabolic Medicine (A.H.A.-R.), Institute of Life Course and Medical Sciences, University of Liverpool, United Kingdom; Department of Neurology and Stroke Centre (G.M.D.M., M.K.), University Hospital Basel and University of Basel; Department of Neurology (Marcel Arnold), University Hospital Bern; Department of Neurology and Stroke Center (T.K., K.N.), Cantonal Hospital Aarau; Department of Neurology (C.W.C.), Neurocenter (EOC) of Southern Switzerland, Lugano; Department of Neurology (G. Kägi), Cantonal Hospital St. Gallen, Switzerland; Neurology Service (A.B.), Germans Trias i Pujol University Hospital, Barcelona; Neurovascular Research Group (J.M.), Biomedicine Institute of Seville, Spain; Department of Internal Medicine (G.N.), Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece; Department of Neurology (C.F.), Goethe University, Frankfurt am Main, Germany; and Institute of Clinical Chemistry (K.S., A.V.E.), University Hospital of Zurich, Switzerland.ORCID 0000-0002-6479-1476
Georg KägiFrom the School of Cardiovascular and Metabolic Health (A.C.C., G. Katsas, J.Y., T.J.Q., R.C., K.D., J.D.), University of Glasgow, United Kingdom; Department of Neurology (Markus Arnold), University Hospital Zurich, Switzerland; Liverpool Centre for Cardiovascular Science (A.H.A.-R.), and Cardiovascular and Metabolic Medicine (A.H.A.-R.), Institute of Life Course and Medical Sciences, University of Liverpool, United Kingdom; Department of Neurology and Stroke Centre (G.M.D.M., M.K.), University Hospital Basel and University of Basel; Department of Neurology (Marcel Arnold), University Hospital Bern; Department of Neurology and Stroke Center (T.K., K.N.), Cantonal Hospital Aarau; Department of Neurology (C.W.C.), Neurocenter (EOC) of Southern Switzerland, Lugano; Department of Neurology (G. Kägi), Cantonal Hospital St. Gallen, Switzerland; Neurology Service (A.B.), Germans Trias i Pujol University Hospital, Barcelona; Neurovascular Research Group (J.M.), Biomedicine Institute of Seville, Spain; Department of Internal Medicine (G.N.), Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece; Department of Neurology (C.F.), Goethe University, Frankfurt am Main, Germany; and Institute of Clinical Chemistry (K.S., A.V.E.), University Hospital of Zurich, Switzerland.
Alejandro BustamanteFrom the School of Cardiovascular and Metabolic Health (A.C.C., G. Katsas, J.Y., T.J.Q., R.C., K.D., J.D.), University of Glasgow, United Kingdom; Department of Neurology (Markus Arnold), University Hospital Zurich, Switzerland; Liverpool Centre for Cardiovascular Science (A.H.A.-R.), and Cardiovascular and Metabolic Medicine (A.H.A.-R.), Institute of Life Course and Medical Sciences, University of Liverpool, United Kingdom; Department of Neurology and Stroke Centre (G.M.D.M., M.K.), University Hospital Basel and University of Basel; Department of Neurology (Marcel Arnold), University Hospital Bern; Department of Neurology and Stroke Center (T.K., K.N.), Cantonal Hospital Aarau; Department of Neurology (C.W.C.), Neurocenter (EOC) of Southern Switzerland, Lugano; Department of Neurology (G. Kägi), Cantonal Hospital St. Gallen, Switzerland; Neurology Service (A.B.), Germans Trias i Pujol University Hospital, Barcelona; Neurovascular Research Group (J.M.), Biomedicine Institute of Seville, Spain; Department of Internal Medicine (G.N.), Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece; Department of Neurology (C.F.), Goethe University, Frankfurt am Main, Germany; and Institute of Clinical Chemistry (K.S., A.V.E.), University Hospital of Zurich, Switzerland.
Joan MontanerFrom the School of Cardiovascular and Metabolic Health (A.C.C., G. Katsas, J.Y., T.J.Q., R.C., K.D., J.D.), University of Glasgow, United Kingdom; Department of Neurology (Markus Arnold), University Hospital Zurich, Switzerland; Liverpool Centre for Cardiovascular Science (A.H.A.-R.), and Cardiovascular and Metabolic Medicine (A.H.A.-R.), Institute of Life Course and Medical Sciences, University of Liverpool, United Kingdom; Department of Neurology and Stroke Centre (G.M.D.M., M.K.), University Hospital Basel and University of Basel; Department of Neurology (Marcel Arnold), University Hospital Bern; Department of Neurology and Stroke Center (T.K., K.N.), Cantonal Hospital Aarau; Department of Neurology (C.W.C.), Neurocenter (EOC) of Southern Switzerland, Lugano; Department of Neurology (G. Kägi), Cantonal Hospital St. Gallen, Switzerland; Neurology Service (A.B.), Germans Trias i Pujol University Hospital, Barcelona; Neurovascular Research Group (J.M.), Biomedicine Institute of Seville, Spain; Department of Internal Medicine (G.N.), Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece; Department of Neurology (C.F.), Goethe University, Frankfurt am Main, Germany; and Institute of Clinical Chemistry (K.S., A.V.E.), University Hospital of Zurich, Switzerland.ORCID 0000-0003-4845-2279
George NtaiosFrom the School of Cardiovascular and Metabolic Health (A.C.C., G. Katsas, J.Y., T.J.Q., R.C., K.D., J.D.), University of Glasgow, United Kingdom; Department of Neurology (Markus Arnold), University Hospital Zurich, Switzerland; Liverpool Centre for Cardiovascular Science (A.H.A.-R.), and Cardiovascular and Metabolic Medicine (A.H.A.-R.), Institute of Life Course and Medical Sciences, University of Liverpool, United Kingdom; Department of Neurology and Stroke Centre (G.M.D.M., M.K.), University Hospital Basel and University of Basel; Department of Neurology (Marcel Arnold), University Hospital Bern; Department of Neurology and Stroke Center (T.K., K.N.), Cantonal Hospital Aarau; Department of Neurology (C.W.C.), Neurocenter (EOC) of Southern Switzerland, Lugano; Department of Neurology (G. Kägi), Cantonal Hospital St. Gallen, Switzerland; Neurology Service (A.B.), Germans Trias i Pujol University Hospital, Barcelona; Neurovascular Research Group (J.M.), Biomedicine Institute of Seville, Spain; Department of Internal Medicine (G.N.), Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece; Department of Neurology (C.F.), Goethe University, Frankfurt am Main, Germany; and Institute of Clinical Chemistry (K.S., A.V.E.), University Hospital of Zurich, Switzerland.ORCID 0000-0002-0629-9248
Christian FoerchFrom the School of Cardiovascular and Metabolic Health (A.C.C., G. Katsas, J.Y., T.J.Q., R.C., K.D., J.D.), University of Glasgow, United Kingdom; Department of Neurology (Markus Arnold), University Hospital Zurich, Switzerland; Liverpool Centre for Cardiovascular Science (A.H.A.-R.), and Cardiovascular and Metabolic Medicine (A.H.A.-R.), Institute of Life Course and Medical Sciences, University of Liverpool, United Kingdom; Department of Neurology and Stroke Centre (G.M.D.M., M.K.), University Hospital Basel and University of Basel; Department of Neurology (Marcel Arnold), University Hospital Bern; Department of Neurology and Stroke Center (T.K., K.N.), Cantonal Hospital Aarau; Department of Neurology (C.W.C.), Neurocenter (EOC) of Southern Switzerland, Lugano; Department of Neurology (G. Kägi), Cantonal Hospital St. Gallen, Switzerland; Neurology Service (A.B.), Germans Trias i Pujol University Hospital, Barcelona; Neurovascular Research Group (J.M.), Biomedicine Institute of Seville, Spain; Department of Internal Medicine (G.N.), Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece; Department of Neurology (C.F.), Goethe University, Frankfurt am Main, Germany; and Institute of Clinical Chemistry (K.S., A.V.E.), University Hospital of Zurich, Switzerland.ORCID 0000-0002-3770-7857
Katharina SpanausFrom the School of Cardiovascular and Metabolic Health (A.C.C., G. Katsas, J.Y., T.J.Q., R.C., K.D., J.D.), University of Glasgow, United Kingdom; Department of Neurology (Markus Arnold), University Hospital Zurich, Switzerland; Liverpool Centre for Cardiovascular Science (A.H.A.-R.), and Cardiovascular and Metabolic Medicine (A.H.A.-R.), Institute of Life Course and Medical Sciences, University of Liverpool, United Kingdom; Department of Neurology and Stroke Centre (G.M.D.M., M.K.), University Hospital Basel and University of Basel; Department of Neurology (Marcel Arnold), University Hospital Bern; Department of Neurology and Stroke Center (T.K., K.N.), Cantonal Hospital Aarau; Department of Neurology (C.W.C.), Neurocenter (EOC) of Southern Switzerland, Lugano; Department of Neurology (G. Kägi), Cantonal Hospital St. Gallen, Switzerland; Neurology Service (A.B.), Germans Trias i Pujol University Hospital, Barcelona; Neurovascular Research Group (J.M.), Biomedicine Institute of Seville, Spain; Department of Internal Medicine (G.N.), Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece; Department of Neurology (C.F.), Goethe University, Frankfurt am Main, Germany; and Institute of Clinical Chemistry (K.S., A.V.E.), University Hospital of Zurich, Switzerland.
Arnold Von EckardsteinFrom the School of Cardiovascular and Metabolic Health (A.C.C., G. Katsas, J.Y., T.J.Q., R.C., K.D., J.D.), University of Glasgow, United Kingdom; Department of Neurology (Markus Arnold), University Hospital Zurich, Switzerland; Liverpool Centre for Cardiovascular Science (A.H.A.-R.), and Cardiovascular and Metabolic Medicine (A.H.A.-R.), Institute of Life Course and Medical Sciences, University of Liverpool, United Kingdom; Department of Neurology and Stroke Centre (G.M.D.M., M.K.), University Hospital Basel and University of Basel; Department of Neurology (Marcel Arnold), University Hospital Bern; Department of Neurology and Stroke Center (T.K., K.N.), Cantonal Hospital Aarau; Department of Neurology (C.W.C.), Neurocenter (EOC) of Southern Switzerland, Lugano; Department of Neurology (G. Kägi), Cantonal Hospital St. Gallen, Switzerland; Neurology Service (A.B.), Germans Trias i Pujol University Hospital, Barcelona; Neurovascular Research Group (J.M.), Biomedicine Institute of Seville, Spain; Department of Internal Medicine (G.N.), Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece; Department of Neurology (C.F.), Goethe University, Frankfurt am Main, Germany; and Institute of Clinical Chemistry (K.S., A.V.E.), University Hospital of Zurich, Switzerland.
Jesse DawsonFrom the School of Cardiovascular and Metabolic Health (A.C.C., G. Katsas, J.Y., T.J.Q., R.C., K.D., J.D.), University of Glasgow, United Kingdom; Department of Neurology (Markus Arnold), University Hospital Zurich, Switzerland; Liverpool Centre for Cardiovascular Science (A.H.A.-R.), and Cardiovascular and Metabolic Medicine (A.H.A.-R.), Institute of Life Course and Medical Sciences, University of Liverpool, United Kingdom; Department of Neurology and Stroke Centre (G.M.D.M., M.K.), University Hospital Basel and University of Basel; Department of Neurology (Marcel Arnold), University Hospital Bern; Department of Neurology and Stroke Center (T.K., K.N.), Cantonal Hospital Aarau; Department of Neurology (C.W.C.), Neurocenter (EOC) of Southern Switzerland, Lugano; Department of Neurology (G. Kägi), Cantonal Hospital St. Gallen, Switzerland; Neurology Service (A.B.), Germans Trias i Pujol University Hospital, Barcelona; Neurovascular Research Group (J.M.), Biomedicine Institute of Seville, Spain; Department of Internal Medicine (G.N.), Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece; Department of Neurology (C.F.), Goethe University, Frankfurt am Main, Germany; and Institute of Clinical Chemistry (K.S., A.V.E.), University Hospital of Zurich, Switzerland.
Mira KatanFrom the School of Cardiovascular and Metabolic Health (A.C.C., G. Katsas, J.Y., T.J.Q., R.C., K.D., J.D.), University of Glasgow, United Kingdom; Department of Neurology (Markus Arnold), University Hospital Zurich, Switzerland; Liverpool Centre for Cardiovascular Science (A.H.A.-R.), and Cardiovascular and Metabolic Medicine (A.H.A.-R.), Institute of Life Course and Medical Sciences, University of Liverpool, United Kingdom; Department of Neurology and Stroke Centre (G.M.D.M., M.K.), University Hospital Basel and University of Basel; Department of Neurology (Marcel Arnold), University Hospital Bern; Department of Neurology and Stroke Center (T.K., K.N.), Cantonal Hospital Aarau; Department of Neurology (C.W.C.), Neurocenter (EOC) of Southern Switzerland, Lugano; Department of Neurology (G. Kägi), Cantonal Hospital St. Gallen, Switzerland; Neurology Service (A.B.), Germans Trias i Pujol University Hospital, Barcelona; Neurovascular Research Group (J.M.), Biomedicine Institute of Seville, Spain; Department of Internal Medicine (G.N.), Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece; Department of Neurology (C.F.), Goethe University, Frankfurt am Main, Germany; and Institute of Clinical Chemistry (K.S., A.V.E.), University Hospital of Zurich, Switzerland.ORCID 0000-0002-9265-8066
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
objectivesProlonged cardiac monitoring (PCM) increases atrial fibrillation (AF) detection after ischemic stroke, but access is limited, and it is burdensome for patients. Our objective was to assess whether midregional proatrial natriuretic peptide (MR-proANP) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) could classify people who are unlikely to have AF after ischemic stroke and allow better targeting of PCM.
methodsWe analyzed people from the Biomarker Signature of Stroke Aetiology (BIOSIGNAL) study with ischemic stroke, no known AF, and ≥3 days cardiac monitoring. External validation was performed in the Preventing Recurrent Cardioembolic Stroke: Right Approach, Right Patient (PRECISE) study of 28 days of cardiac monitoring in people with ischemic stroke or transient ischemic attack and no known AF. The main outcome is no AF detection. We assessed the discriminatory value of MR-proANP and NT-proBNP combined with clinical variables to identify people with no AF. A decision curve analysis was performed with combined data to determine the net reduction in people who would undergo PCM using the models based on a 15% threshold probability for AF detection.
resultsWe included 621 people from the BIOSIGNAL study. The clinical multivariable prediction model included age, NIH Stroke Scale score, lipid-lowering therapy, creatinine, and smoking status. The area under the receiver-operating characteristic curve (AUROC) for clinical variables was 0.68 (95% CI 0.62-0.74), which improved with the addition of log DISCUSSION: MR-proANP and NT-proBNP help classify people who are unlikely to have AF after ischemic stroke. Measuring MR-proANP or NT-proBNP could reduce the number of people who need PCM by 30%, without reducing the amount of AF detected. TRIAL REGISTRATION INFORMATION: NCT02274727; clinicaltrials.gov/study/NCT02274727.
Indexed as
Atrial FibrillationAtrial Natriuretic FactorBiomarkersIschemic StrokeNatriuretic Peptide, BrainPeptide FragmentsAgedAged, 80 and overCohort StudiesFemaleHumansMaleMiddle AgedStrokeAtrial Natriuretic FactorBiomarkersmidregional pro-atrial natriuretic peptide, humanNatriuretic Peptide, BrainPeptide Fragmentspro-brain natriuretic peptide (1-76)
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NCT02274727ClinicalTrials.gov
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